34D2286506 CLIA NUMBER - MANTEO COMMUNITY HEALTH CENTER

Laboratory Demographics

CLIA Number: 34D2286506

Facility Name: MANTEO COMMUNITY HEALTH CENTER

Facility Address:
402 BUDLEIGH STREET
MANTEO, NC
ZIP 27954
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Facility Phone Number: 252 300-3005

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1548046097

Taxonomy: 3336C0002X - Pharmacy
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

CLIA Record

Field Name	Field Value
CLIA Number	34D2286506
LAB Type	Federally Qualified Health Center
Facility Name	MANTEO COMMUNITY HEALTH CENTER
Street	402 BUDLEIGH STREET
City	MANTEO
State	NC
ZIP	27954
Phone	252 300-3005
CertificateType	4
CertificateEffectiveDate	7/31/2023
CertificateExpirationDate	7/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024